Aspectos anatómicos y técnicos de la cirugia de citorredución de cáncer de ovario Epithelial Ovarian Cancer; Debulking of the Superior Abdomen; Abdominal. The mainstay of treatment for advanced ovarian cancer is the multimodality approach of debulking surgery and paclitaxel–platinum chemotherapy. The size of. Download Citation on ResearchGate | Primary or delayed debulking surgery and treated with primary or delayed (secondary) optimal debulking surgery unless impossible, Cáncer epitelial de ovario: evaluación y cirugía.
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They are particularly useful for maintenance of airway lumen in cases of extrinsic compression Figure 8. When using the flexible scope, the laser tip is positioned just beyond the bukking end of the scope. Effective treatment requires experience with flexible and rigid bronchoscopy. The “Y” stent is appropriate for carinal lesions with associated main stem bronchial involvement Parenchymal sparing surgical techniques are useful in the management of resectable lung cancer with limited bronchial involvement.
This information is paramount to determining treatment feasibility. From Wikipedia, the free encyclopedia. Most lung cancers are parenchymal or hilar in location. They may be used as a point of reference throughout a patient’s course of therapy. Although we use this modality more often for endoluminal control of unresectable esophageal cancer, it can certainly be applied to advanced lung cancer with airway involvement.
Laser therapy can be curative in the treatment of granulomas if the source of mechanical irritation is addressed as well. Debridement may require the use of the rigid bronchoscope. Major complications include airway fire, hypoxemia, airway perforation, exsanguinating hemorrhage bhlking pneumothorax. They could not demonstrate any improvement in the detection of histologic abnormalities over white light bronchoscopy The patient is sequestered from direct sunlight and bright indoor light during this time period.
Despite the potential complications associated with endobronchial Nd: There is a wide variety of this type of carcinomatosis depending on the peritoneal involvement, from small and superficial nodes near the primary tumor to a complete occupation of the abdominal cavity by big invasive tumor deposits. This medical treatment —related article is a stub.
Again, proximal stent placement in the setting of complete airway occlusion serves no useful ciirugia and should be avoided.
Debulking – Wikipedia
These symptoms may very well represent local progression, or indicate the failure of therapeutic modalities such as external beam radiation or chemotherapy. A coagulation profile including PT, PTT, and platelet count are of paramount importance, especially when cirugiaa therapy is being considered.
Endobronchial management of benign, malignant, and lung transplantation airway stenoses. Rev Fr Mal Respir ; 7: Physical examination should include but not be limited to an evaluation of the patients overall condition including respiratory status, breath sounds and een organ perfusion. It is imperative to map the proximal and distal extent of gross disease at the time of bronchoscopy. We therefore recommend that patients avoid direct cirygia and eye exposure to sunlight for at least 30 days following injection.
Lastly, a cardiac assessment should be performed, as many of these patients will likely have concomitant cardiac dysfunction. Pathogenesis of systemic air embolism during bronchoscopic Nd: Central airway cancer may also represent tumor recurrence in cases of surgically resected disease. With the exception of carcinoid tumors and rare localized endobronchial squamous cell cancer in good risk patients, endobronchial palliation is the mainstay in the treatment of patients with unresectable endobronchial malignancies.
Special attention to detail and judicious use of the laser will avoid untoward events in most cases. This complication can be avoided by using the endobronchial laser in the noncontact mode or by using a fluid coolant. The stent is positioned at the tip of the rigid scope, just beyond the chest tube Figure 6.
Lesions located distally along the airway are generally not amenable to rigid bronchscopy. One complication is airway fire. The covered portion is placed in contact with the tumor to prevent tumor ingrowth within the stent interstices.
Benign tumors were particularly amenable to laser therapy secondary to a mostly polypoid and localized tendency. YAG laser therapy demonstrated a high cure rate for benign masses as well as carcinoid tumors. This may be suggested by aerated lung or patent bronchial passages on CT scan.
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J Bronchol ; 3: J Natl Cancer Inst ; This therapy, introduced by Dougherty et al, demonstrated necrosis in various tumor types 16, During this time period, the laser is kept in the “disarmed” mode. This approach may require several treatments to achieve a successful thermal necrosis of central and distal airway tumors. The photocoagulated tissue may then be debrided with the tip of the flexible instrument. YAG laser with a wavelength of 1, nm delivers near infrared radiation via a flexible quartz fiber.
Endobronchial tumor may represent too a benign disease process. There were early reports of catastrophic systemic air embolism during Nd: Workup of patients should include basic laboratory indices.
For patients who have undergone therapy for endobronchial tumor, surveillance is necessary to identify recurrent disease early. Our preference is to perform the vascular division and fissure separation prior to bronchotomy.
While LIFE bronchoscopy shows promise in detection of carcinoma in situ in patients with a history of lung cancer, additional trials are likely needed to definitively demonstrate its applicability. PDT is based upon the reactivity of a photosensitizing agent, porfimer sodium Photophrinwhen exposed to laser light at nm wavelength.
Bronchial division is begun proximal to the tumor. Stent position may be adjusted prior to complete deployment.
Ambient indoor light exposure is recommended to assist with inactivation of the remaining drug.